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38 Cards in this Set

  • Front
  • Back
What is the basic structure of the RES?
reticuloendothelial system:
-FIXED macroph/reticulum cells of primary and 2ndary lymphoid tissue
-FREE macroph/histiocytes in spleen/lymph nodes, serous cavities, etc.
-endothelial cells that line liver, 1/2 LT
-circulating monocytes of blood
How is the Lymphatic System comprised?
-Lmph capillaries, ducts, nodes

-lymph drains into inguin/cerv/axill nodes

-nodes trap junk, T/Bcells do their thing.
What is special about the spleen?
The organ w/ both RES and lymph elements.
What is the Spleen's function?
removes foreign particles and aged/deformed RBCs from circulation.
How does the spleen do its job?
when cells pass through, they have to be deformable to go through tiny spaces.

if they're not, they get trapped and removed.

If cells have inclusions spleen PITS them.
Immunological functions occur too
What are the 2 components of the RBC membrane structure?

what is each made up of?
a dynamic structure of
-Lipid bilayer: phospholipids, glycoproteins, proteins, cholesterol

-Skeleton: spectrin, actin, protein 4.1 and 2.1
What is the function of the RBC membrane?
-keep the Hemoglobin in
-critical component of CO2 transport
-its buffering ability facilitates cation passage.
4 things that affect erythrocyte morphology:
-availability of building materials
What are 2 ways to have Spherocytes?
-Decreased Surface area to Vol ratio

-Increased Volume to Surface ratio
What does a decreased SA:Vol ratio mean?
there is not enough membrane to make a nice dimple in the middle, so it's SPHEROCYTIC.
4 Causes of Spherocytes w/ decr. SA:
1. Normal splenic processing causes symmetrical membrane loss.
2. Sensitized membrane partly phatocytosed in immunologic reactions.
3. Burns
4. Impact w/ fibrin, diseased vessel wall causes loss of fragments.
What is the problem in a spherocyte due to volume:SA ratio increase?
there's too much inside the cell - membrane is normal, but can't hold it in, so it's a SPHEROCYTE instead of nice and dimpled.
3 causes of Spherocytosis via too full:
1. Hereditary Spherocytosis
2. Membrane protein abnormality - Spectrin
3. Loss of cell deformability
what is a codocyte? two ways it can be?
a Target Cell
-due to increased SA:V ratio, i.e., there's more membrane than innards

-due to decreased V:SA ratio, i.e., there's not enough innards
Why would codocytes be sean? - 4 reasons
too much membrane:
-Decreased LCAT causes too much cholesterol in membrane
-After splenectomy, the normal plucking of lipids doesn't happen anymore.
Not enough innards:
-Iron deficiency anemia
What are hemoglobinopathies?
problems making Hb.
Sickle cell disease, hemoglobin C disease.
what is LCAT?
lecithin cholesterol acyltransferase - an enzyme in liver that esterifies cholesterol.

when decreased, too much cholesterol is in RBC membranes and Codocytes are seen.
What are Acanthocytes?
Can it be treated?
What 4 things is it seen?
spiny cells
seen in:
-Hepatocellular liver disease
-Pyruvate kinase deficiency
What are Echinocytes?
Are they treatable?
What 3 things are they seen in?
Burr cells - more rounded projections.
Yes, reversible.
Seen in:
1. Uremia
2. Stomach cancer
3. Bleeding peptic ulcers
What are Stomatocytes?
What 5 things induce them?
When are they seen? (3 things)
Smiling cells - uniconcave slits.
-Chlorpromazine, antihistamine, Vitamin A or E, cationic detergents, low pH

Seen in:
-Hereditary Stomatocytosis
-Alcoholic cirrhosis
-Obstructive liver disease
What RBC morphology might be seen in an Rh null patient?
What are elliptocytes, what 2 things might they be seen in?
ovalocytes - potato cells
-Hereditary ovalocytosis
-Megaloblastic anemias
What are Schizocytes, what causes them?

3 things they're seen in:
Fragmented cells from cardiovascular trauma, OR microspherocytes from burns
Seen in:
1. DIC - dissemntd intravascular clotting
2. Thrombotic THrombocytopenia Purpura
3. Malignant Hypertension
what are Dacrocytes?
what are 2 causes?
teardrop cells
-Myelofibrosis - catching on fibrin as the cell pulls away
-Pitting in the spleen - removal of inclusions. Megaloblastic anemia, thallasemia.
what are drepanocytes?
sickled cells
what causes drepanocytes?
is it treatable?
abnormal Hb S - rodlike polymers, so they get stuck in capillaries.

decreased O2 or pH causes sickling.

they're reversible, but repeated sickling causes dmg to membrane.
What are 4 artifcats that can be mistaken as abnormal morphology?
1. too thin of area = spherocytes
2. too thin cuz you're at the edge = pointy, elongated, crowded cells.
3. Donut cells due to drying problem
4. Agglutinated cells stack, look like Rouleaux - true condition is abnormal protein levels so cells fail to repel each other.
what are 6 RBC inclusions

what do they all stain with?
Basophilic stippling
Howell-jolly bodies
Cabot's ring
Pappenheimer bodies
Infectious agents

-All stain with Wright's stain
What causes basophilic stippling?
What 5 diseases is it seen in?
Abnormal or accelerated heme synthesis.

-Lead poisoning
-Sideroblastic anemia
-Megaloblastic anemia
What causes Howell Jolly bodies?
2 diseases they're seen in:
Incomplete expulsion of Nucleus or necrotic chromatin.

Megaloblastic anemia
What is a Cabot's Ring?
What causes it?
3 diseases it's seen in:
a ring or fig 8 that stains red-violet.

It's a microtubule! caused by abnormal mitosis.

Megaloblastic anemia
Homozygous thalassemia
What are Pappenheimer Bodies composed of?

Caused by?

Seen in what?
Micelles of Iron in Swollen Mitochondrias

caused by faulty putting Iron into heme.

-Hemolytic anemia
-Sideroblastic anemia
3 infectious agents that may be seen w/ wright's stain:
-Malarial parasites
-Bartonella bacilliformis
4 RBC inclusions that require SPECIAL stains:
-Heinz bodies
-Hemoglobin H bodies
What stain is used for Retics?
New Methylene Blue or
Brillian Cresyl Blue
What is a siderocyte aka?
What stains it?

What's it composed of?
Pappenheimer bodies
-Perl's Prussian Blue

composed of ferritin
What are Heinz bodies?
What stains them?
When are they seen?
Aggregates of Hb that precipitate when Heme dissociates from globin or enzyme deficiency causes Hb oxidation.

Cresyl Violet, Methyl Violet.

Seen in G6PD, Unstable Hb.
What is a Hb H body?
What stains it?
When is it seen?
Stippling through the RBC
Stained with Brilliant cresyl blue

Too many B globin chains because of alpha thallasemia